"And then she presented this card"

NPR reports on the use of drug company coupons to subsidize the cost of brand drug co-payments.  But what's the big deal if the drug company makes up the difference between their drug and the generic alternative?  Here's the payments for the Solodyn example:

Patient:  $10
Drug company (Medicis):  $154.28
Insurance:  $462.84 (est.)

Most of the insurance payment goes back to the drug company.  They probably made over $300 for a one-month supply of a once-daily version of generic minocycline (~$40).  But my favorite part of the story was when the doctor didn't offer the savings card until AFTER the patient complained about the price.  How many people get to pay the $154 or even the full price?

Some plans now use reference pricing to counter these efforts.  This requires the patient to pay the full amount above what the insurance would have paid for the higher value alternative.  Another method would require the patient to pay the full amount up front, like indemnity insurance, then get reimbursed for the covered amount.  This helps patients understand the true costs of their treatment.

What do you get for an extra $600 per month?  Because Solodyn results in lower blood lets it MAY cause less vestibular effects (e.g., dizziness, tinnitus).  Maybe that extra money will go towards a direct comparison to prove that possibility.